Forbes India 15th Anniversary Special

Dr RS Sharma responds to Forbes India's CoWin story

Dr RS Sharma writes a letter in response to Forbes India's story on India's vaccination platform CoWin, dated July 5, 2021, by Divya J Shekhar. Also, Forbes India editor Brian Carvalho responds to the letter

Published: Aug 6, 2021 01:56:19 PM IST
Updated: Aug 6, 2021 02:30:41 PM IST

Dr RS Sharma, CEO, National Health Authority

Ms Divya J Shekhar's article "India wants to take CoWin global, but it remains disempowering for many back home", published by Forbes India on July 5, 2021, is a classic case of heads I win, tails you lose.

Co-WIN, to make it clear at the outset, is neither a one size fits all solution nor a 100% problem solver. Looking at it with a jaundiced eye, the author has attempted to turn virtue into a vice.

Co-WIN is an advanced digital platform to support India's vaccination drive against COVID-19. It is one of the first digital solutions of its kind, and a robust one at that. It is not a static solution but an evolving one. The fact that it makes India proud and provides a stitch in time to countries, without a digital vaccination platform, is the reason to take it global.

The essence of the case made out by the author is that for illiterate people, residing in remote areas without internet or mobile phones, Co-WIN is a non-starter, and, therefore, instrumental in causing hardship and exclusion. Of course, it is a Luddites argument. Thus armed, one can shoot down the IRCTC ticketing platform - India's most visited e-commerce site, or even the not so widely read digital version of the Forbes magazine. Beyond rhetoric, a dispassionate look at the Co-WIN platform, issue by issue, is essential to understand the matter at hand.

Firstly, Co-WIN pre-empts exclusion, by design. Its phy-gital (physical + digital) nature offers the most simplified registration process both on-site / walk-ins and online. The Co-WIN portal is disability-friendly and compliant with the Guidelines for Indian Government Websites (GIGW). Additionally, to account for language barriers, a choice of 11 regional languages is offered in addition to English.

The self-help online registration facility is complemented by an assisted mode for the technologically challenged. Out of 2,53,13 Gram Panchayats in India, 240,792 have Common Services Centres (CSCs) to assist in accessing the Co-WIN portal. The Palghar district of Maharashtra, referred to in the article, also comprises nine such CSCs, one of which is present in the municipality of Jawhar as well. If that may still be a reason for exclusion, the National Health Authority (NHA) call centre with the helpline number 1075 also enables registration by voice call.

Further, the insistence on ID is functionality driven. The assertion in the said article that “many tribals, including 40 to 50 percent of senior citizens, do not have an ID proof” is preposterous, and this statement can be put to challenge for any region in the country. Let it not be forgotten that 1.29 billion already have Aadhaar. For the remaining, Co-WIN offers the option to choose from 8 other IDs, namely Driving License, PAN card, Passport, Pension Passbook, NPR Smart Card, Voter ID, Unique Disability ID and Ration Card.

An ID facilitates the creation of a digital vaccination record on Co-WIN that has many uses. The vaccine is administered in two doses set apart by weeks. An individual needs to be reminded in good time to get the second vaccine, while also ensuring the same vaccine is administered as was during the first dose. Experience shows for mop-up rounds, intensive individual-centric campaigns to vaccinate the left out will need to be carried out later. Migrant workers need portability to get their vaccination anytime, anywhere. The digital nature of the platform allows for mobility in operations. Vaccination centres can be set up in brick-and-mortar or on the wheels for doorstep service. Co-WIN also provides the beneficiary data to be uploaded on a deferred time basis to accommodate vaccination sessions in remote areas without cellular coverage.

Secondly, in terms of speed and coverage, the pace of vaccination cited by the author has nothing to do with Co-WIN. Vaccinating a billion in a country of India's size, complexity and diversity is mammoth in its own right. The availability of vaccines is subject to global supplies. The figure of 6 crore fully vaccinated individuals mentioned in the article (from July 5) has already grown by over ~50% to 9.65 crores in a mere 23 days. With both the vaccine availability and the pace of vaccination increasing, the tally is achieving new milestones every day. For instance, India set a world record for vaccinating over 90 lakh individuals in one day on June 21, 2021.

Furthermore, a lack of inclusion can’t be blamed entirely on the reliance on a digital system. This fallacious argument is put to rest with the fact that 76.9% of all vaccine doses administered have been through walk-ins till date. With regards to vaccination in rural India, 57% of all vaccination doses delivered have been through rural vaccination centres, with 21% of them being through online registrations.

It bears reiteration that in a country of 1.3 billion+, with a targeted population of 865 million above 18 years to vaccinate, 427.4 million have already registered on the Co-WIN platform, and 348.7 million have received at least one dose of the vaccine. Today’s Digital India has 1,155.77 million wireless telephonic subscribers, 524.11 million in rural areas with a tele-density of 58.85%. The total internet subscribers are 795.18 million with 308.17 million or 34.6 per 100 in rural India. If anyone did the math, one would understand how the provisioning of 4 residents to sign-up under one mobile number is inclusive by design.

Thirdly, the truly credulous fact about Co-WIN that often gets ignored is the robustness of the tech platform with over 400 million registrations in a little over 6 months. This in itself is a feat, as no tech platform has achieved that scale in such a short span of time. The platform also handled 13.7 million registrations, with over 3 billion hits on the website, within 8 hours of being opened to the 18-45 age group. The occasional glitches pointed in the article were exceptions and not unusual for a utility built on the fly in support of an unprecedented global crisis.

Fourthly, coming to privacy and data security, Co-WIN requires minimal data inputs - name, age and gender. It deploys state-of-the-art security protocols that have not been breached to date. Co-WIN does not allow the download of beneficiary data and statistics shared by it aggregated on anonymized data. As a single source of truth, it facilitates coordination between the stakeholders and stems them from information asymmetry. It allows for granular monitoring and precludes rent-seeking by enforcing accountability of supplies received and utilized. At a macro level, Co-WIN aids in making data-driven public health policy decisions and evaluates the performance of each brand of vaccination, through recording and reporting of Adverse Effects Following Immunization (AEFI). Lastly, let us not overlook the global appreciation coming Co-WIN’s way. It is against a stellar performance that the government is planning to take the Co-WIN platform global. Not surprisingly, 405 delegates from over 141 countries, UN Offices in India, and European Union, signed up for the Co-WIN Global Conclave. The event was chaired by the Hon’ble Prime Minister to discuss and disseminate information on Co-WIN with nations from across six continents. In effect, Co-WIN is an ambassador of India's commitment to caring global citizenship.

A case built on exceptions against Co-WIN is disturbing, as it compounds the population-wide vaccination challenge, undermines a sound indigenous technological feat, and gives rise to the ghosts of exclusion and privacy to the detriment of a utility, which has been created in good faith in the interest of the public.

The NHA remains open to dialogue and debate and is committed to a continuous learning process.

This letter has been reproduced in its entirety, without any edits by Forbes India.

Forbes India's Editor responds:

‘India wants to take CoWin global, but it remains disempowering for many back home’ is an extensively-reported and well-researched article whose factual accuracy is corroborated by detailed interviews and conversations with digital privacy experts, academicians, researchers, analysts and representatives of the development sector working on the ground. The article is also balanced, as it includes and highlights perspectives of all stakeholders. Forbes India stands by the story. - Brian Carvalho